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首页> 外文期刊>Surgical Endoscopy >Extended View: Totally Extra Peritoneal (e-TEP) Approach for Ventral and Incisional Hernia-Early results from a single center
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Extended View: Totally Extra Peritoneal (e-TEP) Approach for Ventral and Incisional Hernia-Early results from a single center

机译：延长视图：完全额外的腹膜（E-TEP）腹侧和切口疝气从单一中心的早期结果

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Background Laparoscopy for ventral hernia repair is now an established technique with its proven benefits of less pain, early recovery, low-recurrence rate as compared to open repair. Several techniques have been described such as IPOM, MILOS, TES, EMILOS, SCOLA, e-TEP. e-TEP was originally conceptualized as an alternative approach to inguinal hernia in difficult cases (obese, previous scars) and for training surgery residents. Application of this approach for ventral hernia repair has recently been reported by few surgeons. We present our experience of e-TEP approach for ventral hernia from a tertiary care center in South India over one year duration. Materials and methods Electronically maintained data of patients who underwent e-TEP for ventral hernia during a period of November 2017 to November 2018 was reviewed retrospectively. Their demographic data, intraoperative details, postoperative complications and follow up data for a period of 6 months was noted. Results 171 patients underwent e-TEP approach ventral hernia repair. Mean age was 49.34 +/- 10.75 years with hypertension being most common comorbidity. Mean BMI was 29.2 +/- 4.1 kg/m(2). Mean defect area was 51.35 +/- 45.09 cm(2) and mean mesh size used was 397.56 +/- 208.83 cm(2). Fifty patients required TAR. Mean duration of surgery was 176.75 +/- 62.42 min and blood loss was 78.7 +/- 24.4 ml. Mean length of stay was 2.18 +/- 1.27 days. Seven cases had paralytic ileus, 5 cases had surgical site infection, and 3 cases had recurrence at 6 months follow up. Conclusion e-TEP is a minimally invasive approach which is safe, feasible and also avoids placement of mesh in peritoneal cavity. Since it is a relatively new approach it requires further studies for standardization of techniques, criteria for patient selection and to study long-term outcomes.
机译：背景腹腔镜腹股沟疝修补术是一项成熟的技术，与开放式修补术相比，它具有疼痛小、恢复早、复发率低的优点。已经描述了几种技术，如IPOM、MILOS、TES、EMILOS、SCOLA、e-TEP。e-TEP最初的概念是作为一种治疗腹股沟疝的替代方法，用于治疗疑难病例（肥胖、既往疤痕）和培训外科住院医师。这种方法在腹疝修补术中的应用最近很少有外科医生报道。我们在印度南部的一家三级医疗中心介绍了一年来e-TEP法治疗腹股沟疝的经验。材料和方法回顾性分析2017年11月至2018年11月期间因腹疝接受e-TEP治疗的患者的电子维护数据。记录了他们的人口统计学数据、术中细节、术后并发症和6个月的随访数据。结果171例患者行e-TEP腹疝修补术。平均年龄为49.34+/-10.75岁，高血压是最常见的合并症。平均BMI为29.2+/-4.1 kg/m（2）。平均缺损面积为51.35+/-45.09 cm（2），使用的平均筛孔尺寸为397.56+/-208.83 cm（2）。50名病人需要焦油。平均手术时间为176.75+/-62.42分钟，失血量为78.7+/-24.4毫升。平均住院时间为2.18+/-1.27天。随访6个月，7例出现麻痹性肠梗阻，5例出现手术部位感染，3例复发。结论e-TEP是一种安全可行的微创手术方法，可避免腹膜腔内植入补片。由于这是一种相对较新的方法，因此需要对技术标准化、患者选择标准和长期结果进行进一步研究。

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